Healthcare Provider Details

I. General information

NPI: 1205713633
Provider Name (Legal Business Name): HAVEN WOMEN'S CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8480 S EASTERN AVE STE F
LAS VEGAS NV
89123-2822
US

IV. Provider business mailing address

PO BOX 777447
HENDERSON NV
89077-7447
US

V. Phone/Fax

Practice location:
  • Phone: 702-830-5325
  • Fax: 702-830-4385
Mailing address:
  • Phone: 702-830-5325
  • Fax: 702-830-4385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: KANDY MORRIS
Title or Position: CEO
Credential: DRPH, MPH, CPM, CD
Phone: 702-728-0528